When Nigeria received its certification as free of wild poliovirus five years prior, it marked a proud achievement not only for our nation but for the entire African continent. That day remains vivid in my memory. After decades of tireless work, we had accomplished what many deemed impossible. However, I also recall my words at the time: we can relax one eye, but not both. Complacency presents a risk. Even a single new case necessitates restarting our efforts.
The work persists daily: tracking the virus through wastewater samples in Lagos and Zamfara, addressing outbreaks in Sokoto, and immunizing children through extensive campaigns in urban centers and remote communities. Just this month, Nigeria launched one of its most expansive integrated child health initiatives ever, providing millions of children with vaccines against polio, measles, and rubella, along with other crucial health services. This signifies our considerable progress, yet also underscores the vast coordination, trust, and persistence still required to reach every child.
What propels this endeavor forward isn’t solely data or logistical planning—it’s the relationships forged. Mothers who welcome health workers into their residences. Volunteers who journey long distances to find children. Local leaders who aid in mobilizing their constituencies. And now, a cohort whose contribution has frequently been overlooked is bolstering these initiatives: the spouses of local government chairmen.
In numerous Nigerian regions, the local government chairman functions as the closest equivalent to an elected mayor. These leaders possess an intimate understanding of their communities, and their wives often wield unofficial yet substantial influence: they are mothers, neighbors, and respected voices. Their influence stems not merely from their titles, but from the trust they have cultivated.
In Sokoto, a state where vaccine acceptance has been particularly challenging, the Emergency Operations Center convened these women last month to support immunization efforts. The concept was straightforward: if a mother receives information from another trusted mother—especially one linked to local leadership—she is more inclined to agree to vaccination. And it proved successful. Resistance diminished. Access improved. Dialogues ensued.
For many years, we have engaged traditional and religious leaders in our campaigns, which has yielded immense benefits. Yet, this novel strategy introduces a unique element. It’s a woman-to-woman, mother-to-mother connection—trust cultivated through familiarity, not through authority.
Top-down campaigns or digital communications alone often prove insufficient. What truly works is messaging that is culturally relevant and delivered by individuals whom the community already trusts. This is why Rotary members, also deeply embedded within these same communities, have played a crucial role not only in funding and organizing campaigns but also in dispelling doubts and ensuring no child is overlooked.
Currently, the most potent force in the campaign consists of women vaccinators who conduct door-to-door visits—mothers who are familiar with every household. Even in areas where women encounter obstacles to participation, the trust they establish within communities remains vital for immunizing every child.
In certain scenarios, cultural restrictions or security challenges limit women’s capacity to engage in public-facing health activities such as door-to-door vaccination campaigns. For instance, in specific regions of Afghanistan, female health workers may face challenges like extensive travel distances or other limitations, which hinders consistent community-level outreach. Nevertheless, even in such settings, women continue to fulfill crucial roles, whether through informal networks, as trusted communicators within families, or by supporting access in less overt ways. Even where women encounter these constraints, their established trust and local presence remain central to reaching children.
What commenced as a polio network has evolved into a broader public health platform. These women are not merely discussing polio; they are promoting wider childhood immunizations, advocating for antenatal care, nutrition, maternal health, and supporting HIV testing. The surveillance systems initially developed for polio now track a more extensive array of infectious diseases. This network, grounded in trust and community, must be fortified even after polio is eradicated.
This represents the often-unseen legacy of the polio initiative. Its scope was never solely about polio.
However, challenges persist. Violent conflict, insurgent activity, and criminal actions continue to make efforts difficult. In Nigeria, for example, states such as Borno, Zamfara, and parts of Kaduna and Katsina have been significantly impacted due to armed insurgent groups and banditry, which can restrict or delay vaccination campaigns. These conditions may compel health workers to suspend activities or reroute efforts, leaving groups of children unreached, which in turn allows the virus to persist or re-emerge.
Misinformation also propagates more swiftly than accurate information. One might possess the finest cold chain and an abundance of vaccines, but if those two drops cannot be administered into a child’s mouth, no progress will be made.
When the global effort to combat polio began in 1988, the virus was endemic in over 125 nations. Today, only two persist: Afghanistan and Pakistan. India and Nigeria were once considered the most formidable to reach, yet both demonstrated that eradication was achievable. That is why I believe, with appropriate investment and sustained commitment, these two remaining countries can also follow the path to eradication.
No child should be paralyzed by an illness that is preventable. Health is a fundamental right, not a mere privilege. We are nearly there. But nearly is insufficient. Therefore, until the very last case is gone, I will continue the work I have performed for nearly 40 years.
And perhaps, just perhaps, when that day arrives, I might finally be able to find peace and truly rest.